850 Seminole Rd ELPP19-0021 App ,–� Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: E Lip !c/ —CoOb1J
JOB ADDRESS: 850 SEMINOLE RD, ATLANTIC BEACH, FL 32233 PROJECT VALUE $$ 2,000.00
JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 120 VOLTS 1 PHASE
E NEW SERVICE: ❑Overhead DUnderground Underground up Pole
oResidential (Main) Service:
❑0-100 amps 12101-150amps 13151-200amps 0 amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps 0101-150amps 0151-200amps El amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
❑0-100 amps 1:3101-150amps 0151-200amps ❑ amps #of Unit Meters
ri TEMPORARY POLE: amps
SERVICE UPGRADE: El amps ❑CT Service amps
El NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 1:200amps ❑ amp; ai Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS:
❑Swimming Pool Sign liSmoke Detectors (Qty) ❑Transformers_ KVA ❑Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
✓ REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
Ether:REPLACE 36 METAL HALIDE WITH NEW LED LIGHTS REUSING EXISTING WIRE AND POLES updated 10/17/18
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Owner Name: CITY OF ATLANTIC BEACH, JACK RUSSELLTENNIS Phone Number: (904)247-5834
Electrical Company: B& G REFRIGERATION CO INC Office Phone: (904j 20-0091 Fax:(904)e10-9a15
Co. Address: 3230 KLINE RD City: JACKSONVILLE State. FL Zip: 32246
License Holder: THOMAS CARTER State Certification/Registration#: EC0001181
Notarized Signature of License Holder